Vertical sleeve gastrectomy
In this procedure a cut is made vertically and the larger part of the stomach – up to
85% of its volume – is removed from the body. The remainder is closed with staples to create
a new stomach that is now in the shape of a tube. The procedure preserves both sphincters
at the two ends of the stomach and therefore has minimum effect on the functioning of the
digestive process. This reduces the risk of malabsorptive complications commonly associated
with intestinal bypass. The procedure is irreversible. Vertical sleeve gastrectomy procedure is gaining
more and more popularity thanks to its simplicity and good results on initial weight loss. However,
due to the lack of long-term data, it is yet to be endorsed by bariatric surgery societies
and is not covered by some insurance companies. Adjustable gastric band or Lap band
In this procedure an inflatable silicon band is placed around the top of the stomach to
create a small stomach pouch. The band is connected to a port placed under the skin
of the abdomen. Through this port, a saline solution is injected to adjust the diameter
of the band and thus making the passage between the pouch and the lower part of the stomach
smaller or larger according to the needs of the patient.
During a meal, the pouch is filled up quickly with a small amount of food and releases it
slowly into the lower part of the stomach due to the restriction by the band. As the
pouch is full, it gives the feeling of satiety or fullness and helps to stop the patient
from further eating. Slow passage of the food makes the patient feel full for a longer period
of time and thus reduces the amount of food intake.
As the procedure involves no cutting or stapling of the stomach, it is minimally invasive and
reversible. The surgery can be performed laparoscopically through small incisions with the aid of a
camera. Recovery time is significantly shortened compared to gastric bypass procedures. Also,
as there is no intestinal bypass, the risks of nutritional deficiencies, dumping syndrome
and other complications associated with it are significantly reduced.
In terms of weight loss efficiency, however, patients who undergo gastric lap band surgery
typically lose less weight than those who have had gastric bypass procedures.